The American Academy of Pediatrics (AAP) has updated interim guidance on testing children for SARS-CoV-2 infection, as well as guidance on personal protective equipment (PPE).

The updated interim COVID-19 testing guidance includes recommendations on who should be tested, types of tests, testing recommendations for school, sports, work, and travel clearance, optimal timing for testing, The guideline notes that polymerase chain reaction (PCR) testing is the gold standard for detection of acute SARS-CoV-2 infection. The guidance includes the following recommendations regarding the timing of testing:

  • Patients with symptoms consistent with COVID-19 should be tested without delay using either polymerase chain reaction (PCR) or antigen tests. Testing these patients in a timely fashion is important especially if participating in school, sports, or work so local groups can begin contact tracing, outlining school/work closures, and notifying families to begin home quarantines until test results are received.

  • Asymptomatic patients with close contact exposure to infected persons should not be tested until at least 4 days after exposure. It is important for pediatricians to advise exposed patients to quarantine and wait to test until at least day 4 in order to limit false-negative results and to limit the need for sequential testing.

  • Testing is not generally recommended for indirect exposure such as exposure to a close contact and not directly with the infected person, unless the close contact subsequently tests positive or develops symptoms. Testing is also not recommended for asymptomatic patients who have previously tested positive within the past 3 months. A negative test should not be necessary for return to school/work clearance if the patient has recently tested positive. Patients may have low levels of virus in their bodies and can continue to test positive without risk of spreading the disease to others.

The updated Guidance on the Use of Personal Protective Equipment (PPE) for Pediatric Care in Ambulatory Care Settings During the SARS-CoV-2 Pandemic recommends:

  • When caring for an asymptomatic patient with unknown status: Masks, eye protection, and gowns may be used all day if not soiled or contaminated. If some or all of these items are reusable, these items might be able to be sanitized at the end of the day and reused. If used, gloves should be changed between patients.

  • When caring for a patient with a coronavirus disease 2019 (COVID-19)–compatible illness: Gloves and gown should be removed and disposed of between patients. Eye protection (goggles and/or face shields) should be sanitized between patients. Masks should be changed between patients unless covered by a face shield or another mask.

  • When performing an aerosol-generating procedure (AGP): When performing AGPs, the highest available level of PPE should be used. PPE reuse should follow policies for the care of patients with a COVID-19–compatible illness.

American Academy of Pediatrics (AAP). AAP updates interim guidance on SARS-CoV-2 testing, PPE. October 1, 2020. Available at: click here. Accessed October 19, 2020.